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Mosler Health Care Proposal

1. Government funding for a full time, $8 per hour job that includes full federal health care coverage for the worker and dependents.
   
   This immediately triggers market forces that will result in all businesses providing health care benefits as a matter of competition.
2. As a matter of economics and public purpose it is counter productive for health care to be a marginal cost of production.
   
   No economist will disagree with this. Unless going to work makes one more prone to needing health care, making the cost
   a marginal cost of production distorts the price structure and results in sub optimal outcomes.
   
   Therefore government should fund at least 90% of health care costs paid for by businesses.
3. Long term vision subject to revised details:
• Everyone gets a ‘medical debit card’ with perhaps $5000 in it to be used for qualifying medical expenses (including dental) for the year.
• Expenses beyond that are covered by catastrophic insurance.
• At the end of the year, the debit card holder gets a check for the unused balance on the card, up to $4,000, with the $1,000 to be spent on preventative measures not refundable.
• The next year, the cards are renewed for an additional $5,000.
• Advantages:
1. Doctor/patient time doubled as doctor/insurance company time is eliminated.
2. The doctor must discuss the diagnosis and options regarding drugs, treatments, and costs with the patient rather than an insurance company.
3. Individuals have a strong incentive to keep costs down.
4. Doubling the time doctors have available for patients increases capacity and service without increasing real costs.
5. Total nominal cost of approx. $1.5 trillion ($5,000×300 million people) is about 10% of GDP which is less than being spent today, so even when catastrophic costs are added the numbers are not financially disruptive and can easily be modified.
6. Eliminates medical costs from businesses, removing price distortions and medical legacy costs.
7. May obviate the need for Medicare and other current programs.
8. Eliminates issues regarding receivables and bad debt for hospitals and doctors.
9. Eliminates the majority of administrative costs for the nation as a whole for the current system.
   Patients can ‘shop’ for medical services and prices as desired.
• Disadvantages: Those more in need of the rebate at the end of the year may elect to forgo treatment beyond the $1,500 not subject to the rebate.
• Doctors may be able to more easily convince patients of unneeded treatments and expensive drugs vs insurance companies.

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